Identification of victims from the M/S Estonia

With 852 victims from 17 different countries, the sinking of the Estonia was Europe’s most severe passenger ferry disaster. The Finnish Disaster Victim Identification (DVI) team identified all 93 victims recovered from the sea within 33 days of the accident as well as victim number 94 found 18 months later. Dental identification was established in 57 cases (60%). Received: 2 December 1999 / Accepted: 5 July 2000     

Comparison of knowledge, attitudes and behaviour regarding smoking among Estonian and Finnish physicians

Summary. Objectives: To compare smoking behaviour, attitudes and opinions towards smoking and smoking cessation among Estonian and Finnish physicians. Methods: A cross-sectional postal survey using a self-administered questionnaire was carried out among 2 480 Estonian and 2 075 Finnish physicians. Results: Daily smoking prevalence was higher among Estonian physicians than among their Finnish counterparts in both male (18.6% and 6.7%) and female (6.6% and 3.6%). Compared to Estonia, physicians in Finland more often agreed that smoking is very harmful to their health, that trying to convince people to stop smoking is their responsibility and that smoking prevention should be part of the normal and special training of health professionals. In both countries, non-smoking physicians held more unfavourable attitudes towards smoking than those who were smoking. Conclusions: Physicians’ own smoking patterns and quitting behaviour are important because physicians serve as models for their patients and play a key role in the reinforcement of smoke-free health facilities. These results remain a challenge to medical educators, especially in Estonia. Estonia needs to improve medical education in terms of motivating physicians to ask about the smoking patterns of their patients and of training medical students and resident physicians to counsel their patients to stop smoking.

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Zusammenfassung. Vergleich der Kenntnisse, Einstellungen und des eigenen Verhaltens bezüglich des Rauchens zwischen der estnischen und der finnischen ?rzteschaft Fragestellung: Es werden die Unterschiede in den Rauchgewohnheiten, in der Einstellung und den Ansichten über das Rauchen und die Raucherentw?hnung zwischen estnischen und finnischen ?rzten untersucht. Methoden: Eine Querschnittsstudie mit selbstauszufüllendem Fragebogen wurde bei 2 480 estnischen und 2 075 finnischen ?rzten durchgeführt. Resultate: Die t?gliche Rauchpr?valenz war sowohl bei den ?rzten (18,6%) als auch bei den ?rztinnen (6,6%) in Estland h?her als bei ihren finnischen Kollegen (6,7%) und Kolleginnen (3,6%). Verglichen mit Estland, waren ?rzte in Finnland ?fters der Meinung, dass Rauchen sehr sch?dlich für ihre Gesundheit ist, dass sie dafür verantwortlich sind, ihre Patienten davon zu überzeugen, dass es wichtig ist, aufzuh?ren zu rauchen, und dass Tabakpr?vention ein Teil der normalen und speziellen Ausbildung von Gesundheitsfachleuten sein sollte. In beiden L?ndern hatten nichtrauchende ?rzte gegenüber dem Rauchen eine st?rker ausgepr?gte negative Haltung als die rauchenden. Schlussfolgerung: Dem Rauchverhalten der ?rzteschaft selbst kommt wegen deren Vorbildfunktion gegenüber den Patienten eine Schlüsselrolle bei der Erreichung von rauchfreien Gesundheitseinrichtungen zu. Diese Resultate zeigen, dass die medizinische Ausbildung vor allem in Estland betreffend Rauchen noch ein Verbesserungspotential hat. Estland muss die medizinische Ausbildung so verbessern, dass ?rzte mehr motiviert sind, mit ihren Patienten über das Rauchen zu sprechen. Zudem sollten Studierende der medizinischen F?cher aber auch bereits praktizierende ?rzte dahingehend geschult werden, dass sie ihre Patienten st?rker zur Raucherentw?hnung motivieren k?nnen.

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Résumé. Connaissances, attitudes et comportements des médecins estoniens et finlandais envers le tabagisme Objectifs: Comparer les habitudes de consommation de tabac, les attitudes et les opinions concernant le tabagisme et la cessation tabagique parmi les médecins estoniens et finlandais. Méthodes: Enquête par questionnaire auto administré, auprès de 2 480 médecins estoniens et de 2 075 médecins finlandais. Résultats: La prévalence du tabagisme était plus élevée parmi les médecins estoniens que parmi leurs collègues finlandais, tant pour les hommes (18,6% et 6,7%) que pour les femmes (6,6% et 3,6%). Les médecins en Finlande ont accepté plus souvent qu’en Estonie l’idée que le tabagisme est très nuisible pour leur santé, qu’il est de leur responsabilité de convaincre les gens de cesser de fumer et que la prévention du tabagisme devrait être un sujet normalement abordé dans la formation des professionnels de la santé. Dans les deux pays, les médecins non-fumeurs avaient une attitude plus défavorable envers le tabagisme que les médecins fumeurs. Conclusion: L’attitude des médecins concernant le tabagisme et la cessation tabagique est importante car ils servent de modèles pour leurs patients et ils jouent un r?le-clé pour assurer que le système de santé offre un environnement sans tabac. L’Estonie surtout a besoin d’améliorer la formation des médecins pour inciter ces derniers à interroger leurs patients sur leurs habitudes tabagiques et pour enseigner aux étudiants et aux internes comment informer leurs patients sur les programmes de cessation tabagique.

     

Changing social variations in self-assessed health in times of transition? The Baltic States 1994-1999

BACKGROUND: Dramatic social changes took place in the Baltic States (Estonia, Latvia and Lithuania) in the 1990s. This study investigates the extent to which social variations in self-assessed health changed during that period. METHODS: Norbalt Living Conditions Survey I (1994) and II (1999) random population-based samples in Estonia, Latvia and Lithuania were analysed. Associations of self-assessed health with six social dimensions (education, economic activity, car ownership, number of rooms, ethnicity and residence) were studied for males and females aged 25-74 years (n = 16 970). RESULTS: Substantial and significant associations with poor health were found for education, economic activity, car ownership and, to a lesser extent, number of rooms. Ethnic differences were found only among women in Estonia. By and large, social variations in health were comparable for most indicators between the three countries. Differences in self-assessed health were stable between 1994 and 1999, except for the relatively worse position of the economically non-active in 1999. CONCLUSIONS: Substantial social inequalities in self-assessed poor health exist in the Baltic States. Despite dramatic social changes taking place, social variations in self-assessed health have been rather stable in the second half of the 1990s. The economically non-active seem to have become more disadvantaged.     

Common-pool resources and population genomics in Iceland,Estonia, and Tonga

This paper addresses the application of the ethical concept of trust and the legal and political concept of public trust to population genomics projects in Iceland, Estonia, and Tonga. Focusing on trust and public trust, the paper explores analogies between the genomics projects and the treatment of other common-pool resources, making use of the notion of trust as an ethical demand, derived from the works of Emmanuel Levinas and Knud Eljer Løgstrup. The paper discusses the degree to which the ethical demands for trust and public trust have been established and maintained in the three national population genomics projects.     

Diabetes and social conditions in Estonia. A population-based study

BACKGROUND: The aim of this study was to investigate aspects of metabolic control, treatment and complications as well as quality of life in patients with diabetes mellitus from a defined population in Estonia. METHODS: We invited 220 randomly selected diabetes patients recruited to a clinical investigation from a local diabetes register of 1,100 patients in Viljandi, Estonia. The main outcome measures were derived from medical history, physical examination (height, weight and blood pressure), laboratory variables (blood glucose and glycated haemoglobin A1 (HbA1 normal reference range 3.2-5.6%), serum total and HDL cholesterol and creatinine), a questionnaire on disease-related knowledge and quality of life variables. RESULTS: In all, 181 diabetes patients were investigated, of whom 90% were diagnosed with type 2 diabetes. The mean diabetes duration was 8.9 years from clinical diagnosis and mean HbA1 level was 7.3%. The overall proportion of patients treated with insulin was 29.8% and with anti-hypertensive drugs 26.5%. Smoking was present in 14.3%. The proportion of patients with various diabetes complications was high (73.5%), mostly consisting of different manifestations of cardiovascular disease. Foot ulcers or gangrene were observed in 11.6%. A low level of quality of life was registered in many patients, mostly due to difficult living conditions. CONCLUSIONS: Diabetes patients in Viljandi showed an acceptable degree of glucose metabolic control, but reported a high degree of diabetes complications, as well as impaired quality of life. The diabetes complications may therefore be due to detrimental factors other than hyperglycaemia, e.g. the standard of care during previous years as well as current social and living conditions.     

Seasonal variation in the incidence of Type 1 diabetes mellitus during 1983 to 1992 in the countries around the Baltic Sea.

AIM: To examine seasonal patterns of incidence of Type 1 diabetes mellitus incidence in children aged 0-14 years in Finland, Sweden, Estonia, Latvia and Lithuania during 1983-1992 (1987-1992 for Finland). METHODS: The study used a method that models incidence data using combinations of sine waves to model seasonal variation around a possible linear trend. RESULTS: In Finland, a significant pattern was found for combined sexes and age groups 0-9 and 10-14 years. A significant pattern was also confirmed for 10-14 year-old boys. In Sweden, the best model with significant pattern was found separately for boys and girls and age groups 0-9 and 10-14 years, however, a significant pattern was confirmed for older girls only. A seasonal pattern in older boys in Finland and girls in Sweden was characterized by two cycles with decreased incidence in June and November-December. The pattern among younger children (0-9 or 5-9 years) had one cycle with a decreased incidence in May-June. In Estonia, a significant pattern was found for the age group 0-14 years and combined sexes. No significant seasonal patterns were found in Latvia and Lithuania. CONCLUSIONS: The seasonal pattern with two cycles among older children and one cycle only among younger children may indicate different triggers of Type 1 diabetes mellitus for different age groups.     

The Third Stroke Registry in Tartu, Estonia, from 2001 to 2003

OBJECTIVES: The main goal of the Third Stroke Registry in Tartu was to determine the incidence and 28-day case-fatality of first-ever stroke in an Estonian population. SUBJECTS AND METHODS: Stroke registry was conducted from 1 December 2001 to 30 November 2003. RESULTS: The registry included 451 patients. The incidence rate of first-ever stroke age-standardized to the European population was 188/100,000. Among younger patients, the rates for men dominated. The incidence among men aged 0-44 years was 18/100,000, for women 9/100,000. In the age group 45-54 years, the corresponding rates were 143/100,000 and 98/100,000 respectively. The overall 28-day case-fatality rate was 26%. CONCLUSIONS: The total stroke incidence in Tartu is comparable with other European studies, but the rates for younger patients are higher. This may be associated with lower quality of life, less attention to public health, high prevalence and/or poor control of stroke risk factors. The 28-day case-fatality is somewhat higher than in other European centres.     

Suicide in Estonia

Data on the suicide rate from 1922 to 1935 and from 1965 to 1988 are obtained from annual journals and original documents compiled by the Estonian State Committee for Statistics. During the period of Estonian independence (1922-1935 under consideration), the suicide rate was 16.7 per 100,000 inhabitants at the beginning of the period. During the Great Depression, this figure temporarily rose to 30 and declined to 20.6 in the year 1935. From 1965 to 1985 the suicide rate remained constantly high: on average 33 per 100,000 inhabitants. A decline in the male suicide rate from 55.2 to 36.8 has occurred since 1986. The effects of sociopolitical changes and of limitations on the sale of alcohol on suicide rates are discussed.